Abstract Details

Title Non-invasive Brain Stimulation and Light-based Therapies for Sleep Dysregulation in Major Depressive Disorder: Evidence From a Parameter-stratified Network Meta-analysis of Randomized Controlled Trials

Topic Sleep

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-009

Objective To compare the efficacy of NIBS modalities and bright light therapy (BLT) on sleep outcomes in MDD using a network meta-analysis (NMA) of randomized controlled trials (RCTs).

Background Sleep disturbances are highly disabling in major depressive disorder (MDD), worsening outcomes and quality of life. Neuromodulation approaches, including non-invasive brain stimulation (NIBS) and light-based interventions, have shown promise, but their comparative effects on sleep remain unclear.

Design/Methods PubMed, Embase, Scopus, and ClinicalTrials.gov were searched through July 2025 for RCTs assessing sleep quality, efficiency, or duration with validated measures. Eligible studies compared repetitive transcranial magnetic stimulation (rTMS), intermittent theta burst stimulation (iTBS), transcranial direct current stimulation (tDCS), or BLT against sham controls. Random-effects NMA was performed with sham as reference.

Results Eleven RCTs including 1,076 participants were analyzed. For sleep quality, rTMS at 10 Hz over the left dorsolateral prefrontal cortex (LDLPFC) with adjunctive drugs (MD = –2.49, 95% CI –3.86 to –1.12, p = 0.0004) and BLT at 10,000 Lux for 45 minutes/day (MD = –3.35, 95% CI –6.66 to –0.04, p = 0.0472) were superior to sham. For sleep efficiency, rTMS at 10 Hz LDLPFC (MD = 0.10, 95% CI 0.047 to 0.153, p = 0.0002) and tDCS at 2 mA bilateral DLPFC (MD = 0.05, 95% CI 0.0058 to 0.0942, p = 0.0266) improved outcomes, while BLT did not. For sleep duration, rTMS (SMD = 36.92, 95% CI 9.24 to 64.60, p = 0.0089) and tDCS (SMD = 19.15, 95% CI 3.66 to 34.64, p = 0.0154) increased outcomes, whereas lower-intensity BLT was inferior. No inconsistency was detected, though heterogeneity was high for sleep quality.

Conclusions rTMS and tDCS, when combined with pharmacological therapy, improve multiple sleep domains in MDD. BLT shows selective efficacy, enhancing quality but not efficiency or duration. These findings support integrating neuromodulation and light-based approaches into personalized treatment strategies.

Authors/Disclosures
SAI VENKATA MANOJ KOTHARU, MBBS PRESENTER	Dr. KOTHARU has nothing to disclose.
Muneeb Ahmad Muneer (Allama Iqbal Medical College)	Mr. Muneer has nothing to disclose.
Amatul Aala, MBBS	Miss Aala has nothing to disclose.
Daud Shah, MBBS	Dr. Shah has nothing to disclose.
Rimsha Adnan, MBBS	Miss Adnan has nothing to disclose.
Syeda Ayesha, MBBS	Miss Ayesha has nothing to disclose.
Faris Fayyaz, MBBS	Mr. Fayyaz has nothing to disclose.
Ameer Hamza, MBBS	Dr. Hamza has nothing to disclose.
Areeb Amjad, MBBS	Dr. Amjad has nothing to disclose.
Muhammad S. Saleem, MBBS	Dr. Saleem has nothing to disclose.
Amna Asif, MBBS	Dr. Asif has nothing to disclose.
Farid Ullah, MBBS	Dr. Ullah has nothing to disclose.
Fahad S. Butt, FCPS (Pakistan)	Dr. Butt has nothing to disclose.
Prithvi Pillai, MBBS	Dr. Pillai has nothing to disclose.
Shanza Abbasi, HO	Dr. Abbasi has nothing to disclose.
Dabbara V. Ramana	Mr. Ramana has nothing to disclose.

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